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1. Potential Role of Vδ2+ γδ T Cells in Regulation of Immune Activation in Primary HIV Infection

Author

Nupur Bhatnagar, Pierre-Marie Girard, Moises Lopez-Gonzalez, Céline Didier, Lio Collias, Corinne Jung, Diane Bollens, Claudine Duvivier, Cassandre Von Platen, Daniel Scott-Algara, Laurence Weiss, for the ANRS EP-56 Group, Nadia Valin, Laurent Fonquernie, Marina Karmochkine, Philippe Castiel, Anne Dumont, and Lucie Marchand

Subjects
primary HIV infection, Vδ2+ γδ T cells, immune activation, TGF-β, chronic HIV infection, Immunologic diseases. Allergy, RC581-607
Abstract

Although conventional regulatory T cells (Tregs) are sufficient in controlling low residual T-cell activation in ART-treated patients, they are not efficient in controlling exaggerated immune activation associated with high levels of HIV replication in primary HIV infection (PHI). Our previous data suggested that double negative (DN) T cells including mainly γδ DN T cells play a role in the control of immune activation in PHI. Since γδ T cells are capable of exerting regulatory functions, we investigated their implication as Tregs in PHI as well as chronic HIV infection (CHI). In a cross-sectional study of 58 HIV-infected patients, in the primary and the chronic phase either ART-treated or untreated (UT), we analyzed phenotype and cytokine production of γδ T cells using flow cytometry. Cytokine production was assessed following in vitro stimulation with isopentenyl pyrophosphate or plate-bound anti-CD3/anti-CD28 monoclonal antibodies. We found that the proportion of γδ T cells negatively correlated with CD8 T-cell activation in PHI patients. Furthermore, we found that in these patients, the Vδ2 receptor bearing (Vδ2+) γδ T cells were strongly activated, exhibited low terminal differentiation, and produced the anti-inflammatory cytokine, TGF-β. In contrast, in UT-CHI, we observed a remarkable expansion of γδ T cells, where the Vδ2+ γδ T cells comprised of an elevated proportion of terminally differentiated cells producing high levels of IFN-γ but very low levels of TGF-β. We also found that this loss of regulatory feature of γδ T cells in CHI was a lasting impairment as we did not find recovery of TGF-β production even in ART-CHI patients successfully treated for more than 5 years. Our data therefore suggest that during the primary HIV infection, Vδ2+ γδ T cells may act as Tregs controlling immune activation through production of TGF-β. However, in CHI, γδ T cells transform from an anti-inflammatory into pro-inflammatory cytokine profile and participate in sustenance of immune activation.

Published
2017
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2. Human migration on a heating planet: A scoping review

Author

Rita Issa, Kim Robin van Daalen, Alix Faddoul, Lio Collias, Rosemary James, Umar A. R. Chaudhry, Viola Graef, Adam Sullivan, Panna Erasmus, Heather Chesters, Ilan Kelman, Issa, Rita [0000-0002-0051-5595], Sullivan, Adam [0000-0002-4396-1958], Chesters, Heather [0000-0003-2571-044X], and Apollo - University of Cambridge Repository

Subjects
4403 Demography, Behavioral and Social Science, Basic Behavioral and Social Science, 44 Human Society
Abstract

Whilst people’s migration outcomes may be influenced by climate change, the interaction of heat with migration and migrants is little understood. This scoping review explores the relationship between heat and human migration, focusing on i) whether and how heat functions as a driver of migration, and ii) how migrants are impacted by heat across the migratory journey. Four databases were searched for peer-reviewed literature to identify studies reporting on the heat-migration nexus through 18 June 2021, alongside a grey literature search. Of 12,149 peer-reviewed and 476 grey literature records, 187 articles were screened in full, resulting in the inclusion of 50 records (47 peer-reviewed, 3 grey). Publications assessed the impact of heat on human migration (n = 32), or the experience of heat among migrants (n = 18). In the former, 16/32 report a significant positive association where exposure to heat increases the likelihood of migration or intention to migrate. Moderating factors in the heat-migration pathway include other climatic factors, agricultural productivity, economic opportunities, age, and gender. The vast majority of studies assessing the impact of heat on migrants reported negative impacts of heat (such as heat related illness, heat stress and premature mortality) among migrants compared to non-migrants. Heat impacts were aggravated by poor infrastructure, insufficient workplace adaptations, lower educational level, and socio-economic factors. Findings suggest heat may influence migratory patterns in terms of people’s intention to move, risk when on the move, and consequences of heat for settled migrants. However, the heterogeneous results suggest heat may not be a driver of migration in all contexts. No literature reported on a so-called ‘temperature threshold’ above which migration is certain. Developing comparability in measurements of heat, heat impacts, and definitions of environmentally-induced migration and migrants may support future research on, risk reduction for, and response to the impact of heat on migration and migrants.

Published
2023

3. In-Depth Characterization of Full-Length Archived Viral Genomes after Nine Years of Posttreatment HIV Control

Author

Pauline Trémeaux, Frédéric Lemoine, Adeline Mélard, Marine Gousset, Faroudy Boufassa, Sylvie Orr, Valérie Monceaux, Olivier Gascuel, Olivier Lambotte, Laurent Hocqueloux, Asier Saez-Cirion, Christine Rouzioux, Véronique Avettand-Fenoel, Firouzé Bani-Sadr, Maxime Hentzien, Jean-Luc Berger, Isabelle Kmiec, Gilles Pichancourt, Safa Nasri, Gilles Hittinger, Véronique Lambry, Anne-Cécile Beaudrey, Gilles Pialoux, Julie Chas, Christia Palacios, Anne Adda, Jean Paul Viard, Marie-Josée Dulucq, Laurence Weiss, Marina Karmochkine, Mohamed Meghadecha, Dominique Salmon-Ceron, Marie-Pierre Piétri, Philippe Blanche, Jean-Michel Molina, Olivier Taulera, Diane Ponscarme, Jeannine Delgado Bertaut, Djamila Makhloufi, Matthieu Godinot, Valérie Artizzu, Patrick Miailhes, Laurent Cotte, Sophie Pailhes, Anne Conrad, Ludovic Karkowski, Stanislas Ogoudjobi, Yazdan Yazdanpanah, Sophie Matheron, Cindy Godard, Louis Bernard, Frédéric Bastides, Olivier Bourgault, Christine Jacomet, Emilie Goncalves, Pascal Chavanet, Lionel Piroth, Sandrine Gohier, Agnès Meybeck, Thomas Huleux, Pauline Cornavin, Yasmine Debab, David Théron, Thierry Prazuck, Barbara De Dieuleveult, Jean-Pierre Faller, Patricia Eglinger, Pascal Roblot, David Plainchamp, Hugues Aumaître, Martine Malet, Christine Rouger, Gérard Rémy, Melle Kmiec Isabelle, Jean-Luc Delassus, Alain Devidas, Eric Froguel, Sylvie Tassi, Philippe Genet, Juliette Gerbe, Olivier Patey, Richier Laurent, Marie-Christine Drobacheff, Aurélie Proust, Helder Gil, Laurence Gérard, Eric Oksenhendler, Caroline Lascoux, Sylvie Parlier, Frédéric Lucht, Véronique Ronat, Michel Dupon, Hervé Dutronc, Séverine Le Puil, Didier Neau, Patrick Mercié, Philippe Morlat, Sabrina Caldato, Jean-Luc Schmit, Nathalie Decaux, Jean-Pierre Bru, Gaëlle Clavere, Jean-François Delfraissy, Cécile Goujard, Katia Bourdic, Daniel Vittecoq, Claudine Bolliot, Thierry Lambert, Jean-François Bergmann, Maguy Parrinello, Yves Welker, Alain Lafeuillade, Gisèle Philip, Christophe Rapp, Melle Lerondel, Pierre de Truchis, Berthe Huguette, Vincent Jeantils, Fatouma Mchangama, Paul Henri Consigny, Fatima Touam, Sophie le Nagat, Olivier Bouchaud, Patricia Honoré, François Boué, Mariem Raho-Moussa, Jean-Paul Viard, Agnès Cros, Dominique Salmon-Céron, Marie-Pierre Pietri, Lio Collias, David Zucman, Olivier Blétry, Dominique Bornarel, Emmanuel Mortier, Zeng Feng, Jean-Daniel Lelièvre, Christine Katlama, Yasmine Dudoit, Anne Simon, Catherine Lupin, Pierre-Marie Girard, Michèle Pauchard, Sylvie Abel, André Cabié, Pascale Fialaire, Jean-Marie Chennebault, Sami Rehaiem, Luc de Saint Martin, •••• Perfezou, Jean-Charles Duthe, Pierre Weinbreck, Claire Genet, Florence Garnier, Isabelle Poizot-Martin, Olivia Fauche, Alena Ivanova, Patrick Philibert, Mame Penda Sow, Patrick Yeni, Cyndi Godard, François Raffi, Hervé Hüe, Philippe Perré, Pierre Marie Roger, Aline Joulie, Éric Rosenthal, Christian Michelet, Faouzi Souala, Maja Ratajczak, Marialuisa Partisani, Patricia Fischer, Pascale Nau, Pierre Delobel, Florence Balsarin, Marc De Lavaissiere, Renaud Verdon, Philippe Feret, Pascale Leclercq, •••• Gerberon, Agnés Meybeck, Raphaël Biekre, Thierry May, •••• Bouillon, François Caron, David Theron, Marc Gatfosse, Martin Martinot, Anne Pachart, Patrice Poubeau, Catherine Gaud, Agnès Uludag, Philippe Arsac, Lydia Bouaraba, Barbara de Dieulevault, Isabelle De Lacroix Szmania, Laurent Richier, Vincent Daneluzzi, Elisabeth Rouveix, Geneviève Beck-Wirth, Philippe Romand, Laurent Blum, Martine Deschaud, Christophe Michau, Christian Bernard, Florence Salaun, Philippe Muller, Yves Poinsignon, Annie Lepretre, Albert Sotto, •••• Doncesco, Pascale Perfezou, Jean Charles Duthe, Mathilde Aurore Niault, Virginie Mouton-Rioux, Jean-Philippe Talarmin, Jean Charles Duthé, Mathilde Dupont, Stéphane Natur, Hikombo Hitoto, and Ali Mahamadou Ibrahim

Subjects
Microbiology (medical), Infectious Diseases, General Immunology and Microbiology, Ecology, Physiology, Genetics, Cell Biology
Abstract

Most people living with HIV need antiretroviral therapy to control their infection and experience viral relapse in case of treatment interruption, because of viral reservoir (proviruses) persistence. Knowing that proviruses are very diverse and most of them are defective in treated individuals, we aimed to characterize the HIV blood reservoirs of posttreatment controllers (PTCs), rare models of drug-free remission, in comparison with spontaneous controllers and treated individuals.

Published
2023
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4. γδ T-cell subsets in HIV controllers

Author

Mathieu F. Chevalier, Pierre-Marie Girard, Claudine Duvivier, Moises Lopez-Gonzalez, Lio Collias, Céline Didier, Corinne Jung, Diane Bollens, Juliette Pavie, Laurence Weiss, Daniel Scott-Algara, Nupur Bhatnagar, Régulation des Infections Rétrovirales, Institut Pasteur [Paris], Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), Cytokines et Inflammation, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre d'infectiologie Necker-Pasteur [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Pasteur [Paris], Université Sorbonne Paris Cité (USPC), This study was supported by the Agence Nationale de Recherches sur le SIDA et les Hépatites Virales (ANRS). M.F.C and N.B received a grant from the ANRS., We thank all patients who participated in this study. We also thank Rita Affa who provided support for on-site project implementation, and management of ethical and regulatory clearance under the supervision of Nathalie Jolly (CRT Clinical Core, Institut Pasteur, Paris). We thank the Pasteur Institute (Paris) for promoting the study, and Françoise Barré-Sinoussi and Jean-Marc Cavaillon for their scientific support., ANRS-EP56 Group included Nadia Valin and Laurent Fonquernie, Hôpital Saint Antoine, Paris, Marina Karmochkine, and Philippe Castiel, Hôpital Européen Georges Pompidou, Paris, Véronique Avettand-Fénoël, Hôpital Necker-Enfants malades, Paris. Anne Dumont and Lucie Marchand, Service des recherches cliniques sur les hépatites virales et le VIH, ANRS INSERM, Paris, France., Institut Pasteur [Paris] (IP), Institut Pasteur [Paris] (IP)-CHU Necker - Enfants Malades [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Adult, Male, 0301 basic medicine, endocrine system, T cell, T gd 17, Immunology, Human immunodeficiency virus (HIV), HIV Infections, Viremia, medicine.disease_cause, immune activation, HIV Long-Term Survivors, interleukin-17, Flow cytometry, 03 medical and health sciences, 0302 clinical medicine, transforming growth factor- b, Antigen, T-Lymphocyte Subsets, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Humans, Immunology and Allergy, Medicine, Cytotoxic T cell, 030212 general & internal medicine, Receptor, chronic HIV infection, medicine.diagnostic_test, business.industry, HIV controllers, virus diseases, Receptors, Antigen, T-Cell, gamma-delta, Middle Aged, Flow Cytometry, medicine.disease, 3. Good health, 030104 developmental biology, Infectious Diseases, medicine.anatomical_structure, Cytokines, Female, gd T cells, business
Abstract

International audience; OBJECTIVES:HIV controllers (HICs) are rare HIV-infected individuals able to maintain undetectable viremia in the absence of antiretroviral treatment. Although HIV-specific cytotoxic T cells have been well deciphered in HIC, γδ T lymphocytes remain largely uncharacterized. The aim of this study was to analyse phenotypic and functional characteristics of γδ T cells and their relationship with immune activation, which remains abnormally elevated and associated with comorbidities in HICs.METHODS:Peripheral blood mononuclear cells (PBMCs) were isolated from 16 HICs, 16 patients with untreated chronic HIV infection (UT-CHI) and 20 healthy donors. Surface marker expression and cytokine production by γδ T cells were analysed by flow cytometry.RESULTS:Despite normal frequencies of total γδ T cells, the Vδ2/Vδ2 ratio was significantly reduced in HIC, albeit to a lesser extent than UT-CHI patients. Of note, nine HICs showed elevated Vδ2 γδ T cells, as patients with UT-CHI, which was associated with higher CD8 T-cell activation. Interleukin (IL)-17-production by γδ T cells (Tγδ17) was better preserved in HIC than in UT-CHI patients. Proportion of total γδ T cells positively correlated with CD8 T-cell activation and HIV-DNA, IP-10 and sCD14 levels. Conversely, Tγδ17 cells negatively correlated with CD8 T-cell activation and plasma sCD14 levels. Moreover, transforming growth factor (TGF)-β producing Vδ2 T cells were as dramatically depleted in HIC as in UT-CHI patients.CONCLUSION:The relative preservation of IL-17-producing γδ T cells in HIC and their negative association with immune activation raise the hypothesis that Tγδ17 cells - potentially through prevention of microbial translocation - may participate in the control of chronic systemic immune activation.

Published
2019
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5. Comparison of anal cancer screening strategies including standard anoscopy, anal cytology, and HPV genotyping in HIV-positive men who have sex with men

Author

Pauline Boucheron, Lio Collias, Sophie Grabar, Laurence Weiss, David Veyer, Hélène Péré, Marie-Laure Lucas, Simon Pernot, Juliette Pavie, Nadia Fathallah, Julien Taieb, Jeanne Netter, and Vincent de Parades

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Genotype, Cytodiagnosis, Anal Canal, HIV Infections, Physical examination, Article, Men who have sex with men, Sexual and Gender Minorities, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Anal cancer, 030212 general & internal medicine, Homosexuality, Male, Genotyping, Early Detection of Cancer, Gynecology, Human papillomavirus 16, Intraepithelial neoplasia, medicine.diagnostic_test, business.industry, Papillomavirus Infections, HIV, virus diseases, Anoscopy, Gold standard (test), Middle Aged, Anus Neoplasms, medicine.disease, female genital diseases and pregnancy complications, Anal cytology, Oncology, 030220 oncology & carcinogenesis, France, business, Papanicolaou Test
Abstract

Background There is no consensus on screening strategy of high-grade intraepithelial neoplasia (HGAIN). Guidelines range from clinical examination with digital anorectal examination followed by standard anoscopy (SA), to anal cytology (Pap)+/− HPV genotyping. We compared screening strategy yields based on Pap, SA, and HPV-16 genotyping alone or in combination in HIV-MSM. Methods Pap, SA, and HPV-16 genotyping were performed in all HIV-MSM attending a first anal cancer screening consultation in Paris, France. High-resolution anoscopy, the gold standard to detect HGAIN, was performed in the case of HPV-16 positivity or abnormal cytology. Yield was defined as the number of patients with HGAIN relative to the total number of patients screened. Results On 212 patients, the complete strategy (SA + Pap + HPV genotyping) yield (12.7%) was significantly higher than that of SA (3.3%, p

Published
2018
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6. Factors associated with anal cancer screening uptake in men who have sex with men living with HIV: a cross-sectional study

Author

Marie-Laure Lucas, Lio Collias, Juliette Pavie, Hélène Péré, Sophie Grabar, Laurence Weiss, Simon Pernot, Alexis Vanhaesebrouck, and Julien Taieb

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Paris, Epidemiology, Cross-sectional study, MEDLINE, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Ambulatory Care Facilities, Men who have sex with men, 03 medical and health sciences, Sexual and Gender Minorities, 0302 clinical medicine, Patient Education as Topic, Risk Factors, Surveys and Questionnaires, Medicine, Anal cancer, Humans, 030212 general & internal medicine, Early Detection of Cancer, business.industry, Obstetrics, Public Health, Environmental and Occupational Health, Age Factors, Cancer, Odds ratio, Middle Aged, medicine.disease, Anus Neoplasms, Confidence interval, Cross-Sectional Studies, Oncology, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, Patient Compliance, business
Abstract

Most western countries have guidelines on anal cancer screening for men who have sex with men (MSM) living with HIV. However, adherence to these guidelines has been studied poorly. This cross-sectional study reports anal cancer screening uptake and identifies the factors associated with a previous screening in MSM living with HIV in a Paris Hospital (France). A total of 410 outpatients completed a self-administered questionnaire on anal cancer screening. The median age was 50 years and the median time from HIV diagnosis was 14.2 years. Overall, 82.2% of patients were aware of anal cancer screening and, of these, 56.7% had already undergone a screening test. The absence of history of screening (43.3%) was most often explained by lack of time (31.3%) or information (28.2%). Among patients familiar with the anal screening procedure, those older than 50 years (adjusted odds ratio=2.4, 95% confidence interval=1.3-4.7, P=0.007) and informed by healthcare providers (adjusted odds ratio=8.2, 95% confidence interval=2.5-32.0, P=0.001) were more likely to have already been screened. To date, adherence to anal cancer screening in MSM living with HIV appears to be inadequate to enable diagnosis of cancer at its early stages. Encouraging physicians to inform MSM living with HIV about anal cancer screening, irrespective of their age, could be an effective strategy to improve anal cancer screening uptake.

Published
2019

7. Four-days-a-week antiretroviral maintenance therapy in virologically controlled HIV-1-infected adults: the ANRS 162-4D trial

Author

Claire Rouzaud, Véronique Joly, Babacar Sylla, Jacques Leibowitch, Lio Collias, Noemie Biezunski, Dominique Costagliola, Damien Le Dû, Jacques Izopet, Irène Zamord, Jonathan Bellet, Sandrine Gohier, Julie Chas, Dominique Bornarel, Sylvie Dargere, Karine Amat, Olivier Bouchaud, Jean-Claude Melchior, David Zucman, Martin Duracinsky, Huguette Berthe, Roland Landman, Adrien Lemaignen, Soizic Le Mestre, Lionel Piroth, Arnaud de la Blanchardiere, Amélie Chabrol, Emuri Abe, Pierre Delobel, Dominique Mathez, Frédéric Fourreau, Juliette Saillard, Louis Bernard, Laurence Weiss, Jean-François Delfraissy, Stéphanie Landowski, Jean-Claude Alvarez, André Cabié, Pierre-Marie Girard, Lambert Assoumou, Luminita Schneider, Jean-Luc Meynard, Jacques Reynes, Karine Lacombe, Alain Devidas, Mathilde Pircher, Fatima Touam, Séverine Gibowski, Pierre de Truchis, Guillaume Gras, Aida Benalicherif, Christian Perronne, Vincent Le Moing, Christine Katlama, Pélagie Thibault, Cécile Goujard, Bao Phung, AP-HP Hôpital Raymond Poincaré [Garches], Institut Pierre Louis d'Epidémiologie et de Santé Publique ( iPLESP ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Infection, Antimicrobiens, Modélisation, Evolution ( IAME ), Université Paris Diderot - Paris 7 ( UPD7 ) -Université Paris 13 ( UP13 ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Hôpital Bretonneau, CHRU Tours, Hôpital avicenne, Université Paris 13 ( UP13 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Avicenne, Recherche Clinique ville-hôpital, Méthodologies et Société ( REMES ), Université Paris Diderot - Paris 7 ( UPD7 ), Infection et inflammation chronique ( 2IC ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre de physiopathologie de Toulouse Purpan ( CPTP ), Université Paul Sabatier - Toulouse 3 ( UPS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), ANRS, Service des maladies infectieuses et tropicales [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Hôpital Raymond Poincaré [AP-HP], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital Avicenne [AP-HP], Recherche Clinique ville-hôpital, Méthodologies et Société (REMES), Université Paris Diderot - Paris 7 (UPD7), Infection et inflammation (2I), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), ANRS France Recherche Nord & sud Sida-hiv hépatites, Services des Maladies Infectieuses et Tropicales [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1)

Subjects
0301 basic medicine, Microbiology (medical), Adult, Male, Pediatrics, medicine.medical_specialty, 030106 microbiology, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Drug Administration Schedule, Plasma viral load, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, Maintenance therapy, Quality of life, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Longitudinal Studies, Pharmacology, business.industry, [ SDV.SP.PHARMA ] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Middle Aged, Viral Load, 3. Good health, CD4 Lymphocyte Count, Clinical trial, Regimen, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Infectious Diseases, Treatment Outcome, Tolerability, Anti-Retroviral Agents, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, HIV-1, Quality of Life, RNA, Viral, Reverse Transcriptase Inhibitors, Drug Therapy, Combination, Female, business
Abstract

International audience; Background:Intermittent treatment could improve the convenience, tolerability and cost of ART, as well as patients' quality of life. We conducted a 48 week multicentre study of a 4-days-a-week antiretroviral regimen in adults with controlled HIV-1-RNA plasma viral load (VL).Methods:Eligible patients were adults with VL 90%, with a power of 87% and a 5% type 1 error. The study was registered with ClinicalTrials.gov (NCT02157311) and EudraCT (2014-000146-29).Results:One hundred patients (82 men), median age 47 years (IQR 40-53), were included. They had been receiving ART for a median of 5.1 (IQR 2.9-9.3) years and had a median CD4 cell count of 665 (IQR 543-829) cells/mm3. The ongoing regimen included PI/r in 29 cases and NNRTI in 71 cases. At 48 weeks, 96% of participants (95% CI 90%-98%) had no failure while remaining on the 4-days-a-week regimen. Virological failure occurred in three participants, who all resumed daily treatment and became resuppressed. One participant stopped the strategy. No severe treatment-related events occurred.Conclusions:Antiretroviral maintenance therapy 4 days a week was effective for 48 weeks in 96% of patients, leading to potential reduction of long-term toxicities, high adherence to the antiretroviral regimen and drug cost saving.

Published
2018
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